Child Growth and

Development

Chapter 12:

Physical Development &

Health in Middle

Childhood

Prepared by

Debbie Laffranchini

From Papalia, Olds, and Feldman

• Height and Weight

• Tooth Development and

Dental Care

• Brain Development

Aspects of

Psychological

Development

Height and Weight

• Growth in middle childhood slows considerably – Children grow 2 – 3 inches a year

– Double their weight between 6 and 11

• Girls retain more fatty tissue than boys

• African American girls have more muscle and bone mass than European American or Mexican American girls

• Mexican American girls have higher percentage of body fat than white girls the same size

Tooth Development

and Dental Care • Most adult teeth arrive in middle

childhood

• Primary teeth begin to fall out about

age 6

• Permanent teeth are replaced at

about four teeth per year for five

years

• Number of untreated cavities

dropped nearly 80% for children 6 –

18 years since 1971

– Improvements attributed to use of

sealants on the rough, chewing surfaces

Brain Development

• Brain development during childhood is less

dramatic than during infancy

– Important changes occur

• Loss in density of gray matter in certain regions

of the cerebral cortex

– Reflects pruning of unused dendrites

– Balanced by steady increase in white matter

• Axons or dendrites that transmit information between

neurons to distant regions of the brain

• These changes increase speed and efficiency of

brain processes

Brain Development

• Thickness of the cortex changes – Temporal and frontal lobes that handle language

• Thinning in the rear portion of the frontal and parietal cortex in the brain’s left hemisphere – Correlated with improved performance on the

vocabulary portion of an intelligence test

• Corpus callosum myelination leads to rapid transmission of information between two hemispheres

• Sex differences – Boys have markedly greater loss in gray matter and

growth in white matter and corpus callosum fibers

– Girls have same changes but slower rate

Losses in gray matter density reflect maturation of

various regions of the cortex, permitting more efficient

functioning.

Nutrition and

Sleep •Nutritional Needs

•Sleep Patterns and

Problems

Nutritional Needs

• School children need 2,400 calories a day* – More for older children, less for younger

• 30% of total calories from fat

• Less than 10% of total calories from saturated fat

• Fruit juice and sweetened beverages should be limited to 8 – 12 ounces daily

• Media strongly influences children on what to eat

• Nutrition education can be helpful when combined with parental education and changes in school lunch menus

• You are the parent; you decide what goes into the grocery cart and into your child!

Sleep Patterns and Problems

• Sleep needs decline from 11 hours a day at 5 years

• Age 9: 10 hours

• Age 13: 9 hours

• Sleep problems are present in part due to children setting their own bedtime

– Resistance to going to bed, insomnia, daytime sleepiness

• 40% of school-age children have TV in their room

– These children get less sleep than other children

• Family stress is associated with lower sleep quality

• 1 in 5 children in one study had significant sleep difficulties

– Most parents were unaware of them

• Sleep problems are highly correlated with psychological and behavioral problems

Motor

Development

& Physical

Play • Recess-Time Play

• Organized Sports

Recess-Time Play

• Motor skills improve in middle childhood

• In US, children’s lives are more sedentary

• Children spend less time in sports and other outdoor activities than in the early 1980’s

– Spend more hours on schooling and homework

– Spend more hours watching television

• Average screen time: 12 – 14 hours a week*

• Boys play more physically active games

• Girls favor games that include verbal expression or counting aloud

– Hopscotch and jump rope

• Rough and tumble play peaks – Universal: hormonal differences in

boys and girls, socialization

Recess in Kenya

Gender Choices: Girls (Left),Boys

(Right)

Organized Sports • After rough-and-tumble outgrown,

games with rules emerges

• 39% of 9 – 13-year-olds play organized sports

• Baseball, softball, soccer, basketball

• 77% of children play unorganized activities

• Bicycling, shooting baskets

• Girls spend less time on sports • Spend more time on housework,

studying, personal care

• Organized sports improves motor skills, immediate and long-term health benefits

• Organized sports should include all children, focus on building skills rather than winning, include variety of sports for lifetime fitness (tennis, bowling, swimming, running, golf, skating)

• 6 – 9 years need flexible rules, shorter instruction time, more free time for practice

Health &

Safety •Overweight and Body Image

•Medical Conditions

•Factors in Health and Access to

Health Care

•Accidental Injuries

Overweight and Body Image

• Overweight in children is major health issue worldwide

• Since 1980 childhood obesity increased in almost all countries

• By 2010, nearly 50% of children in North and south America will be overweight

• In US 19% of school-age children are overweight – 3 times as many as 1980

• Concern with body image contributes to eating disorders – Playing with Barbie dolls may influence

Overweight and Body Image

Causes of Overweight • Inherited

• Too little exercise

• Too much of wrong kinds of foods

• Overweight parents or other relatives

• Poor nutrition

• Media advertising

• Wide availability of snack foods and beverages

• Inactivity is major factor* – National Association of State Boards of Education

recommends 150 minutes of physical education a week

• Preadolescent girls in ethnic minorities, children

with disabilities, children in public housing,

children in unsafe neighborhoods most likely to

be sedentary

Overweight and Body Image: Why is Childhood Overweight a Serious Concern?

•Overweight is decided disadvantage for school-age children

•Fall behind classmates in physical and social functioning by age 10

•Overweight children often suffer emotionally

•May compensate by indulging with treats

•Overweight children at risk for behavior problems, depression, low self-

esteem

•Overweight children have more medical problems

•High blood pressure

•High cholesterol

•High insulin levels

•Overweight children tend to become obese adults

•High blood pressure, heart disease, orthopedic problems, diabetes

• Childhood overweight may be a stronger predictor of some diseases than

adult overweight

•Girls overweight before puberty nearly 8 times more likely to be overweight

adults

Overweight and Body Image:

Prevention and Treatment • Prevention is easier, less costly, and more effective than treatment

• Effective weight-management programs should include – Parents

– Schools

– Physicians

– Communities

– Larger culture

• What works – Less time in front of television and computers

– Changes in food labeling

– Changes in advertising

– Healthier school meals

– Education for better food choices

– More time in physical education

– Parents make exercise family activity (hiking, playing ball, walking, use stairs)

• Treatment should begin early and involve life changes, not just

weight loss

Overweight and Body Image

Overweight and Childhood

Hypertension

• Once relatively rare in childhood

now “evolving epidemic” of

cardiovascular risk

– Especially ethnic minorities

• Average blood pressure rose in

children 8 – 17 years

• Weight reduction through dietary

modification and regular physical

activity is primary treatment for

overweight-related hypertension

Medical Conditions

• Development of vaccines

for major childhood illness

has made middle childhood

relatively safe time of life*

• Illness tends to be brief

(acute)

• Children’s understanding

of health and illness is

cognitive

– Explain disease better, not

magical, not transductive

Medical Conditions

Vision and Hearing Problems

• Keener vision in middle childhood

– Under 6 years, children tend to be farsighted

– By 6, vision more acute, two eyes better

coordinated, focus better

• 13% of children under 18 years

estimated to be blind or have impaired

vision

– Vision problems reported more often for

white and Latino children than African

Americans

• 15% of children 6 – 19 years have some

hearing loss

– Preponderance of boys

Medical Conditions

Stuttering • Involuntary audible or silent

repetition or prolongation of

sounds or syllables

• Usually begins between 2 and 5

years

• Neurological condition

• No known cure – Speech therapy may help

• Two factors at work: 1. Structural or functional disorder of the

CNS

2. Parental reactions that may provoke

anxiety

• http://www.youtube.com/

watch?v=tEitDTX2ZAo

Medical Conditions Asthma

•Chronic (long-term)

•Respiratory disease

•Allergy-based

•Coughing, wheezing, difficulty breathing

•Increasing worldwide

•12.7% of US children up to 17 years diagnosed with

asthma

•More common in boys

•Doubled in US between 1980 and 1995

•Third leading cause of hospitalization of children in US

•Black children 20% more likely to be diagnosed (even

adjusting for SES)

•Twice as likely to have visited ER in year

•Causes: uncertain, genetics, environment, smoke,

molds, cockroach droppings, pets, antibiotics

•Miss average 10 days of school

Medical Conditions

HIV and AIDS • 2.2 million children worldwide

– High risk of developing AIDS

– 2004 ½ million died of AIDS

• Prospects have improved due to antiretroviral

therapy

• Most school-age children function normally

– Quality of life may be affected

• Virtually no risk of infecting peers

• Should be encouraged to participate in school

activities, including sports

• Early detection is critical

Factors in Health and Access

to Health Care • Social disadvantage plays important

part in children’s health

– Disproportionately minority children

– Single parent

– Low educational status

• More likely to have chronic condition

• More likely to miss school due to illness

or injury

• More likely to be hospitalized and have

unmet medical and dental needs with

delays to care

• 1/3 of children with chronic health

problems underinsured

• 60% of all children have coverage gaps

of at least 4 months

• Differing beliefs and attitudes about

health care and healing (culture)

Accidental Injuries

• Accidental injuries leading cause of death

in school age

– Boys more likely to be injured

– Boys more likely to have repeat injury

• 23,000 children suffer serious brain

injuries from bicycle accidents

– 88% of injuries could be prevented by

using helmets

• Protective headgear is vital for many

sports

– Helmets, goggles, mouth guards

• Minimize “heading” ball

• AAP recommends:

– No children under 16 on snowmobiles

– No trampolines

Cultural Attitudes Affect Health

Care • Adherence to ancient beliefs about illness is

common in industrialized parts of world

• Many cultures see illness and disability as a

form of punishment who has transgressed in this

or a previous life

– Or their ancestor

• Imbalance of elements in the body causes

illness (Southeast Asia and Latin America)

• Religious households might hold out for a

miracle and refuse surgery or treatment

Cultural Attitudes Affect Health

Care

Australian Medicine Man Navajo Medicine Man

Cultural Attitudes Affect Health

Care

Blood Letting with Leech Southeast Asia: Coining

Cultural Attitudes Affect Health

Care Native American

Medicinal Pipe

Native American Healing

through Songs

Cultural Attitudes Affect Health

Care

Medicine Dance Stick Blood letting

Cultural Attitudes Affect Health

Care

Ancient Labyrinth Herbal Healing

To be yourself in a world that is

constantly trying to make you

something else is the greatest

accomplishment.

-Ralph Waldo Emerson